| NPI | 1568910263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: NY 131624228) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2016-09-12 |